Joint Mobilization: Cervical and Thoracic Spine

Introduction

This course describes joint mobilizations for the cervical spine and thoracic spine. Several terms and definitions have been used to describe the "mobilizations" (e.g. mobilisations) that are taught in this course. The Brookbush Institute uses a conventional definition of "mobilization" that includes low amplitude, low-velocity, oscillatory techniques intended to reduce the stiffness of joints exhibiting a decrease in passive accessory range of motion (a.k.a. arthrokinematic motion and specifically glide or slide). Note, the term "manipulation" is reserved for high-velocity techniques taught in a separate set of courses. Further, the types of mobilizations taught in this course are posterior to anterior (PA) and include both unilateral posterior to anterior (UPA) mobilizations directing force over facet joints, and central posterior to anterior (CPA) mobilizations directing force over the spinous process. These mobilization techniques likely represent the most commonly recommended techniques due in part to their relatively high reliability and efficacy.

This course includes mobilization techniques that intend to improve excessive stiffness of the cervical spine and thoracic spine, improve restrictions in spine range of motion (ROM), and reduce cervicothoracic and upper extremity dysfunction. For example, cervical dysfunction has been correlated with lateral epicondylitis, and mobilizations of the cervical spine have been correlated with a reduction in pain and improvements in function, such as increased grip strength. These techniques may also be used in an integrated approach for cervicothoracic dysfunction, and upper body dysfunction (UBD) including cervicogenic headache, shoulder impingement syndrome (SIS), lateral epicondylitis (tennis elbow), chronic thoracic pain, chronic neck pain, and acromioclavicular dysfunction, and postural dysfunctions including rounded shoulder posture, forward head posture, thoracic kyphosis, or an anterior pelvic tilt. Some evidence and clinical outcomes even suggest that addressing cervical dysfunction and forward head posture can improve long-term outcomes for low back pain patients.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based, systematic, integrated, patient-centered, and outcome-driven approach.

Techniques Covered in this Course:

• Cervical Mobilization (Manual)
• Thoracic Mobilization (Manual)

Sample Intervention (Cervicothoracic Junction Pain/Stiffness)

• Manual Release
  • Levator Scapulae
  • Upper Trapezius
  • Rhomboids
  • Pectoralis Minor
• Mobilization or Manipulation
  • Cervical Mobilization
  • Thoracic mobilization
• Manual Lengthening
  • Manual Pectoralis Minor Stretch
• Activation
  • Deep Cervical Flexor Activation
  • Serratus Anterior Activation
• Integration
  • Cobra on Foam Roll

Related Courses

Additional Joint Mobilization Courses

• Joint Mobilizations: Ankle and Tibiofibular Joints
• Joint Mobilizations: Knee and Hip Joints
• Joint Mobilizations: Lumbar Spine and Sacroiliac Joints
• Joint Mobilizations: Cervical and Thoracic Spine
• Joint Mobilizations: Shoulder, Sternoclavicular, and Acromioclavicular Joints
• Joint Mobilizations: Elbow and Proximal Radioulnar Joints

For an introduction to joint mobilizations and manipulations:

• Joint Mobilization and Manipulation: Introduction
• Joint Mobilization and Manipulation: Reliability
• Joint Mobilizations and Manipulations: Effects
• Joint Mobilization and Manipulation: Risk of Adverse Effects
• Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning